Despite injuries, veterans can't get in-vitro help

They met in college while on the Washington State University rowing team. After graduating, Sean Halsted followed in the tradition of his family and joined the Air Force. The sweethearts then married, looking forward to a life together of promise and children.

Everything changed one day in 1998: Sean fell 40 feet while fast-roping from a helicopter during a training exercise and damaged his spinal cord. He was left paralyzed from the waist down.

During the next several years the Halsteds rebuilt their lives - ones that didn't necessarily include a future with children.

"Sexual function is completely different," Sean Halsted said. "Basically the concept of having kids wasn't going to work. It was not only just the biomechanics, but also the concept that I'm in a chair. It was hard enough for me to live life. I didn't have anything left for kids. My wife was not happy with that concept."

It was several years later, while Sean watched a friend compete in wheelchair games, that the Halsteds' lives would be steered back to their dreams of family.

It wasn't his friend's athleticism that impressed him. It was watching his friend be a dad.

"It gave me the perception that kids are possible," he said. "So we started looking into the procedures we needed to do."

The Halsteds discovered they were ideal candidates for in-vitro fertilization - a procedure that involves fertilizing a woman's egg outside the body and then implanting it in the womb. They were dismayed, however, to learn the U.S. Department of Veterans Affairs doesn't cover the costly but effective procedure.

According to Sean Halsted, the VA told him it wasn't their responsibility.

"They wanted to help," he said. "I don't mean to say they turned a cold shoulder. It just wasn't their field. It just wasn't in their consciousness. It was like, 'Your body is healthy, we've got you on the rehab stuff, our job is done.'?"

In an odd twist of how the government treats its military men and women, severely injured active-duty personnel qualify for the procedure in some cases, but the VA doesn't cover it for veterans.

"It was a shocker," Sean Halsted said. "I'm not painting them as a bad guy, but they're busy. If you're already busy, you're not looking for more things to do."

The Halsteds, who live in Rathdrum, paid $20,000 out of their own pocket for the procedure. It was an expense they say many veterans and their spouses can't afford.

But two bills making their way through Congress could give more injured veterans hope they can still have a family.

Human cost of war

Improvements in battlefield medicine mean more servicemen and -women survived blasts from the land mines and improvised explosive devices frequently used by insurgents in Iraq and Afghanistan. Some returned with injuries making it impossible for them to have children.

"A lot of the injuries that occur in the line of duty can only be managed in terms of using in-vitro fertilization," said Dr. Lori Marshall, medical director of the Pacific Northwest Fertility and IVF Specialists. "They may result in infertility, and there is no other treatment that would allow that couple to conceive except in-vitro fertilization."

The VA covers some reproductive care, but IVF is not included. The average cost of the procedure is $12,000 to $15,000.

The federal legislation would offer fertility treatment for veterans' spouses, as well as for gestational surrogates, which may be needed if a female veteran's uterus is damaged or removed. The current lack of coverage for a surrogate is a problem, Marshall said, in light of the increasing role women are playing on the battlefield.

"If you don't cover the partner, you're not really covering in-vitro fertilization," she said. "If you don't cover the gestational surrogate, you're not really covering it. You're not really taking care of the injury completely, and not really allowing all the couples that need to have care to have the care that they need."

Since 2003, more than 1,800 U.S. military members have suffered injuries in Iraq or Afghanistan that impact the reproductive tract.

The bills also include research on the the long-term medical needs of veterans with reproductive injuries.

"There are injuries that are occurring that are things that haven't really been seen that much," she said. "And so we actually don't know everything that we should know about the long-term care and what are the consequences of some of the injuries."

Though the Department of Defense provides coverage of IVF through Tricare for some active-duty men and women, it often takes years to recover from severe injuries, and many are veterans by the time they are ready to have kids.

"I think it would be hard for anyone to argue that this shouldn't be done," Marshall said of the push for more comprehensive reproductive care for veterans. "I think most people feel that's just a no-brainer."

The bills, called the Women Veterans and Other Health Care Improvements Act of 2012, aim to close those gaps in coverage. They're sponsored by Sen. Patty Murray and Rep. Rick Larsen, both Washington Democrats.

"The VA has an obligation to care for the combat wounded, and that should include access to the fertility care they need," Murray said. "We should not force families to spend tens of thousands of dollars of their own money to start a family."

She said the VA is slowly adapting to the needs of veterans and hopes to improve care through the bill, which would also create a pilot program to provide child care to veterans seeking counseling at the VA's Vet Centers.

"These veterans deserve far more," she said. "For a severely wounded veteran and his or her spouse, their infertility is yet another human cost of war. The commitment we have to our veterans is non-negotiable, regardless of the fiscal cost."

'They're all miracles'

The Halsteds have been busy since the life-changing injury in 1998.

Through in-vitro fertilization they now have 8-year-old twins, a boy and a girl, and a 3-year-old daughter. All their children were conceived at the same time, but the embryo of their youngest was frozen and implanted later.

"They're all miracles," Sarah Halsted said. "It's just phenomenal the way that technology allowed us to have our children. We're just so lucky, so incredibly blessed."

The only way the Halsteds could afford the IVF was because of a medical malpractice settlement stemming from a botched medical procedure.

The couple don't want other veterans to suffer from the inability to have the sense of fulfillment their family provides them.

Sean Halsted, a Paralympian and former combat controller, credits the VA for the help it has given him but said it needs to adapt its coverage to current medical technology to meet the needs of those injured in the line of duty.

"What you're saying to those soldiers is, 'We don't value your service enough to give you a normal life after your sacrifice,'?" he said. "That, to me, is at the core of it. You're expected to have a normal life, but if you can't have kids, what kind of life is that? Are you really still normal?"